| NPI | 1285638718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANGELINE Regulatory Compliance Analyst Ii 714-961-2102 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 979078-47) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2024-12-18 |